@theliverdoc@sureshchowdhary please update us on the results too. There are tons of toxicants (like pesticides) that can do acute liver damage in way less than 3 weeks; but honestly within the herbal realm, there are only a few that can do it (and that do due to some synergistic effects).
@theliverdoc Your patient has one sick sense of humor :( Many years ago we had a acute on chronic liver failure patient (I just ran tox screens for a paper) but he gave us each a bottle of sparkling wine that Christmas (told us it was low alcohol so didnt matter lol).
GLP-1 does much more than weight loss (liver, cardiovascular, diabetes), so if your doc prescribes you that, seriously consider it rather than believing "influencers" that admonish GLP-1 usage and keep bringing up rare side effects as reasons to refrain from it.
A recent case study shows that Tirzepatide (aka mounjaro) reversed stage 4 cirrhosis to stage 1/2 which was confirmed by biopsy and not only by non invasive fibroscan/MRE. This goes against general wisdom that cirrhosis is irreversible!
While this was only a case study and we absolutely need large scale trials to show this; however, after semaglutide getting indicated for MASH, we can expect tirzepatide to get same indication too.
@theliverdoc I am on calorie reduction and this makes me hungry! jokes aside, its a nice balanced meal; there is something special in kerala plantains; they taste so much better than what I used to get in Atlanta at cuban stores (I ate lots of fried plantains called maduros during college)
@theliverdoc For those that want RCT level evidence behind this suggestion, please do a search on "mediterranean diet" along with other keywords that you want (like NAFLD, NASH resolution etc.). I cant speak for @theliverdoc but my assumption is that the diet he suggested is that itself. 1/2
1/ Wild data from protein powder market: Plant proteins use 88% natural sweeteners. Whey? 52% artificial.
Same category. Completely different philosophies. 🧵
@theliverdoc I think many people miss the key word "healthy" here.
Lots of veg patients get omega 3 + vitamin E prescribed if they got such a prescription, they shouldn't try to stop it without consultation.
Wasnt it a standard prescription even for NAFLD 5-10 years ago?
@witchdrkochi@theliverdoc unfortunately I dont know much about retail pricing (I am more on the other side), this is something doctors like @theliverdoc or the patients can tell you better. However, I can say that hetero drugs and couple of other indian pharma companies do have nepal presence for this.
@theliverdoc My bad, I hadnt seen my morning linkedin feed due to long weekend when I replied to you; just saw US FDA approval for sema for F1-F3 NASH (but not for F4 cirrhosis). Great step, you got additional options now for your patients!
@theliverdoc I guess you are mentioning sema due to Sanyal (2025) paper. Are you sure sema is approved now for NASH cirrhosis ? Just a caveat, Semaglutide phase 2 trial on NASH cirrhosis didnt find any statistical evidence of hitting the endpoint.
@witchdrkochi@theliverdoc Wasnt there a way to get it from Nepal (legally) on compassionate grounds? technically resmetirom isnt approved in india so Indian docs can "recommend" it but prescribing it might put them in legal soup hence they tend to avoid it (except on compassionate grounds).